ATI - pain Flashcards
define pain threshold vs pain tolerance
threshold: point which a person perceives pain; min
tolerance: level of pain they will endure; max
transduction
sensory neurons feels tissue damage through neurotransmitter sensitization of nociceptors
how do NSAIDs work
block products of pain response such as prostaglandins
transmission
pain impulse travels from peripheral nerves to somatic sensory cortex where pain is perceived
how do opioids work
inhibits pain transmission from peripheral nerves to somatic sensory cortex
why use adjuvant medications such as antidepressants
they modulate pain by promoting reuptake of endorphins
what does the gate-control theory say
- pain varies between the balance of non-nociceptive info traveling into spinal cord via large nerve fibers + nociceptive info traveling through spinal cord through small nerve fibers.
- if the large nerve fibers are more active, the gate is closed and person should feel little to no pain.
- if the smaller nerve fibers are more active, the projector neurons will activate and block inhibitory neurons, which then leads to pain.
BIG idea: nondrug therapy works for pain
OPQRST mnemonic
Onset
Provocation
Quality
Region
Severity
Time
define acute vs. chronic pain
acute: resolves after damaged tissue heals
chronic: persists 6 months or more past the expected healing time
side effects of acute pain
sympathetic nervous system activates: increased HR, BP, diaphoresis, pallor, dry mouth, nausea, bronchiolar dilation, etc.
reduced gastric secretion/motility, increased bg, decreased urine output
side effects of chronic pain
vitals become stable so behavioral changes are more noted: depression, withdrawn.
pain-reducing substances are depleted and pain msg is sent faster so increases pts response to pain.
define nociceptive pain
- damage or inflammation of tissue.
- somatic (msk) or visceral.
define neuropathic pain
- abnormal or damaged pain nerves
- ex: postherpetic neuralgia (adjuvant meds better instead of typical opioids or NSAIDS), phantom pain
idiopathic pain
chronic pain that continues despite no detectable cause
ex: complex regional pain syndrome
referred pain
starts in one region from actually in another region
ex: gall bladder dx feels pain in shoulder blade
radiating pain
pain felt near the source
intractable pain
defies relief
ex: advanced maglignancies
infants perception of pain
crying or withdraw
toddlers perception of pain
crying or anger
pain is associated with punishment or threat to their security
school-age children or adolescents perception of pain
view pain as weakness
tend to not acknowledge right away
learn certain acceptable pain such as sports
adults perception of pain
how they learned to express pain as a child
older adults perception of pain
dx that impair perception of pain such as neuropathy, chronic pain
reluctant to express pain
patient teachings for when to give meds
tell pt to tell you when pain is mild and after intervention, reassess no more than 1 hr after
when do IV and oral pain meds peak
IV: 30 mins
oral: 1 hr
CRIES scale usage, and stands for
for infants: 0-6m
scores 0-2 in 5 categories
Crying
increase in O2 REquirement from baseline
Increase in vitals
Expression on face
Sleeping
FLACC scale usage, and stands for
for infants and kids 2m-7yrs old when not verbal
Facial expression
Leg movement
Activity
Crying
Consolabiliity
what pain scale is used for advanced dementia pts
PAINAD
Breathing, negative vocalization, facial expression, body language, consolability
when is the COMFORT behavioral scale used
pts who can’t use traditional numeric rating or FACES scale
biofeedback therapy
devices with electrode sensors that monitor physiological response to pain, to help the pt determine what methods are good for relieving their pain
how fast should IV opioids be injected
slowly over 4-5 mins
